Long-term Efficacy and Safety of Lamivudine, Entecavir, and Tenofovir for Treatment of Hepatitis B Virus-Related Cirrhosis

被引：77

作者：

Koklu, Seyfettin ^{[1
]}

Tuna, Yasar ^{[2
]}

Gulsen, Murat Taner ^{[3
]}

Demir, Mehmet ^{[4
]}

Koksal, Aydin Seref ^{[5
]}

Kockar, Muhammet Cem ^{[6
]}

Aygun, Cem ^{[7
]}

Coban, Sahin ^{[8
]}

Ozdil, Kamil ^{[9
]}

Ataseven, Huseyin ^{[10
]}

Akin, Ebru ^{[11
]}

Purnak, Tugrul ^{[12
]}

Yuksel, Ilhami ^{[13
]}

Ataseven, Hilmi ^{[14
]}

Ibis, Mehmet ^{[15
]}

Yildirim, Beytullah ^{[16
]}

Nadir, Isilay ^{[17
]}

Kucukazman, Metin ^{[18
]}

Akbal, Erdem ^{[19
]}

Yuksel, Osman

Basar, Omer

Alkan, Erhan

Baykal, Ozlem ^{[6
]}

机构：

[1] Hacettepe Univ, Sch Med, Dept Gastroenterol, Ankara, Turkey

[2] Akdeniz Univ, Sch Med, Dept Gastroenterol, TR-07058 Antalya, Turkey

[3] Gaziantep Univ, Sch Med, Dept Gastroenterol, Gaziantep, Turkey

[4] Mustafa Kemal Univ, Sch Med, Dept Gastroenterol, Antakya, Turkey

[5] Yuksek Ihtisas Hosp, Dept Gastroenterol, Ankara, Turkey

[6] Suleyman Demirel Univ, Sch Med, Dept Gastroenterol, TR-32200 Isparta, Turkey

[7] Firat Univ, Sch Med, Dept Gastroenterol, TR-23169 Elazig, Turkey

[8] Diskapi Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey

[9] Umraniye Educ & Res Hosp, Dept Gastroenterol, Istanbul, Turkey

[10] Selcuk Univ, Sch Med, Dept Gastroenterol, Konya, Turkey

[11] Ataturk Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey

[12] Numune Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey

[13] Etlik Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey

[14] Cumhuriyet Univ, Sch Med, Dept Gastroenterol, Sivas, Turkey

[15] Gazi Univ, Sch Med, Dept Gastroenterol, Ankara, Turkey

[16] Ondokuz Mayis Univ, Sch Med, Dept Gastroenterol, Samsun, Turkey

[17] Fatih Univ, Sch Med, Dept Gastroenterol, Ankara, Turkey

[18] Kecioren Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey

[19] Ankara Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2013年 / 11卷 / 01期

关键词：

Liver Function; Varices; Ascites; HCC Incidence; SEVERELY DECOMPENSATED CIRRHOSIS; AWAITING LIVER-TRANSPLANTATION; DISOPROXIL FUMARATE TDF; ADEFOVIR DIPIVOXIL; NAIVE PATIENTS; THERAPY; MANAGEMENT; SURVIVAL; OUTCOMES; ADULTS;

D O I：

10.1016/j.cgh.2012.10.003

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

BACKGROUND & AIMS: Data are limited on the efficacy and safety of tenofovir and entecavir when given for more than 1 year to patients with hepatitis B-related cirrhosis. We investigated the long-term safety and efficacy of these antiviral drugs in patients with chronic hepatitis B virus (HBV) infection, with compensated or decompensated cirrhosis, and compared results with those from lamivudine. METHODS: We performed a retrospective analysis of data from 227 adult patients with chronic HBV infection who were diagnosed with cirrhosis, beginning in 2005, at 18 centers throughout Turkey. There were 104 patients who had decompensated cirrhosis, and 197 patients were treatment naive before. Seventy-two patients received tenofovir (followed up for 21.4 +/- 9.7 mo), 77 patients received entecavir (followed up for 24.0 +/- 13.3 mo), and 74 patients received lamivudine (followed up for 36.5 +/- 24.1 mo). We collected data on patient demographics and baseline characteristics. Laboratory test results, clinical outcomes, and drug-related adverse events were compared among groups. RESULTS: Levels of HBV DNA less than 400 copies/mL were achieved in 91.5%, 92.5%, and 77% of patients receiving tenofovir, entecavir, or lamivudine, respectively. Levels of alanine aminotransferase normalized in 86.8%, 92.1%, and 71.8% of patients who received tenofovir, entecavir, and lamivudine, respectively. Child-Turcotte-Pugh scores increased among 8.5% of patients who received tenofovir, 15.6% who received entecavir, and 27.4% who received lamivudine. Frequencies of complications from cirrhosis, including hepatic encephalopathy, variceal bleeding, hepatocellular carcinoma, and mortality, were similar among groups. Lamivudine had to be changed to another drug for 32.4% of the patients. CONCLUSIONS: Tenofovir and entecavir are effective and safe for long-term use in patients with compensated or decompensated cirrhosis from HBV infection.

引用

页码：88 / 94

页数：7

共 26 条

[1]

TWO YEARS SAFETY AND EFFICACY OF TENOFOVIR DISOPROXIL FUMARATE (TDF) IN PATIENTS WITH HBV-INDUCED CIRRHOSIS [J].